Document LpEoLLEY02Ex4NRXYOkLqdVLw

COPY November 5, 1043 Mr. i>. French Beeves, Vic President I K. A. Koerber, M. D., Plant Physician 2013 Oxford street Philadelphia, Bonne. Dora July 4, 1S99 kraployed May 9, 1920 a submit herewith an abstract of the medical record Samples of blood and urine hare been submitted for analysis. These were taken according to the specific instruction of the Kettering Laboratory. This patient's annual physical examinations, aside from his lead history, have been essentially negative since 1932 un March 30, 1933, he was first examined by the undersigned, who records him to have been in the bhite-Lead Lepartment for sixteen years and to have had a lead line, oral sepsis and moderate post cervical adenopathy. At that time his blood studies showed a hemoglobin of GO, red blood cells 4,020,000, stippling 4/, which means that he had froxa three to ten stippled cells per oil immersion field. Annual examination of November 14, 1936 showed a hemoglobin of 70, H. B* 0, 3,940,000, stippling 3/, a very faint trace of albumin and a few hyaline casts. January 11, 1938, physical examination was essentially negative except for hemoglobin of 69, it. B. C. 3,820,000, 3tippling S / t albumin a very faint trace, February 20, 1939, hemoglobin 86, u , B. 0. 4,410,000 and occasional stippled cell. February 9, 1940 hemoglobin was 83, A. B. 0, 3,960,000, occasional stippled cell, cloud of albumin, ten to fifteen white blood cells, .arch 20, 1941, patient had a blood pressure of 160/110, h. B. 0* 3,820,000, hemoglobin 90, cloud of albumin, hyaline casta, eight to ten white blood cells, bassemans in 1936, 1937, 1938, 1939, 1940 and 1941 negative. His dispensary record from 1936 forward included the usual run of headaohes, colds, intestinal disturbances and occasional minor non-related injuries from which he recovered and a fracture of radius and ulna on July 2, 1943, from which he has fully recovered. K 0013787 -- Continued-- N16593 COPY tAr* 3. jKrenoh i%eeves, V, P November 5, 43 2 This man's sexual life bears watching. In 1936 he reported married Tor sixteen years, no children living or dead. October 10, 1939 he reported mere approach of female causes orgasm. Gotober 8, 1940, dispensary record carries this rota tion: "Apparently a nymphomaniac. Now complains again of same condition as on 10/10/39. Painful testicles, no injury, no excesses, no swelling." From that date to the present date, this patient has complained continually of pains and swelling In the loft testicle and impotence. At no time has the undersigned found any subjective findings to substantiate his subjective complaint. The en tire genitalia and inguinal region and perineum were found to be negative on physical examination, on January 1, 1943, the patient reported that he was no longer impotent, following the use of strychnine 1/60 after meals. This patient has been examined at monthly intervals, he report herewith the dates when positive findings occurred, the rest of the record being essentially negative. July 13, 1936 to November 10, 1938, this patient presented a hemoglobin which would fluctuate between 60 end 92 and a stippling which would fluctuate between negative end 3/, with the exception of September 8, 1936 when it -.vac 4/. subjectively, the patient offered no complaint, from November 10, 1938 to tiarch 3, 1941, the patient's lead history was essentially negative except for an occasional stippling or 1/ stip pling. His lowest hemoglobin had been 76 and his highest 100, generally fluctuating between 60 and 93. from 1941 to September of 1942 this patient's blood presented an occasional to a 3/ stippling and a hemoglobin which varied from 77 to 98 and an occasional aniseo cytosia, poikilo cytosis and polychramaaia. from October 1942 to the present date, this patient has presented only once an occasional stippled cell otherwise always having been negative, ilia lowest hemoglobin 72 and his highest 100, generally fluctuating between 00 end 06. This patient from time to time was considered to have had excessive absorption of lead and various orders were issued from time to time, which are given ea follows; September 1936 the patient received calcium therapy, intravernously raid by mouth. In 1938 he was reported as "always dirty, sloppy habits." In November 1938 he was recorded as having been in Sunshine Gang a number of times and then placed on a ro tating schedule a number of times and returned to the .hits-Lead Lapartment on the block on September 26, 1938. The block is a wet process. Hay 1940 he was placed on Vitamin 0 and noticed no change in his general feeling of well being, in March 1941 wa recorded him as having been in white-lead filling, no dry lead, since Sep tember 1938, prior to this in the Sunshine Gang and prior to that a miller in mill house for a number of years, also in jail for nine months. April 1941 he was again placed on Vitamin G for two weeks. In September 1941 an attempt was made to delead with ammonium chloride but ha was unable to tolerate this and he was given calcium lactate. In February 1942 ha received calcium glu conate intraveatnously. From Jebtuafyr until June he received several courses of calcium therapy, at the end of which time he was again started on a course, on June 26, it was recorded "Has boon assigned to water mill for one hour daily." August 21, 1942, it wa3 recorded, "Remove permanently from lead hazard." -- Continued-- f 3 COPY Sir* 1 french Reeves, V ** November 5, 43 on September 23, 1942 was recorded, "Frequent aohromic cells, no stippling, ;enerai condition improved.11 In October, "Continue on block, slowly improved. *' This order was continued to the present date. It is believed advisable to explain our method of calculation of stippled cells. 1/ is one stippled coll per two oil icaersion fields, 2/ is one stippled cell per field, 3/ is two per one field and V is three or more per field. It la believed that our Bunshine and rotating gangs need explanation. .Vhen an individual has excessive absorption or intoxication due to lead, he is removed from Uia haaard and placed on what wo call our uuashine Gang, This is a yard gang that have odd jobs thruout the promises in the open air and free from any exposure to lead, hen the individual hau bean on the iiunshine gang a sufficient length of time to have Jiad satisfactory hemoglobin ana u. B, C. and absence of stippled ceils for a period of three months, he is placed upon what we call our rotating gang, idis is the same group as the iiunshine Gang except that they re turn to their former occupation by successive degrees. If all goes well, it takes approximately four months full time to their regular job. luring the first month they return to their occupation for one week and then to the iunshine Gang for three weeks. If the blood studios show continued improvement, the next month they return to their regular occupation for two weeks and into the unshine two weeks, The third month they are in their regular job for three weeks and in the sunshine for one week, if all has gone well, they are returned the fourth month for regular occupation for a full month. This patient has come thru this procedure a number of times and has been out of the load haaard since August 1342. Hi3 work on the block is ''wet." The work on the water mill does produce a wet spray which we have considered a hazardous occu pation. He was last assigned to this duty in June 1942 for but one hour dally to oversee this work and have another man trainod to replace him. After sixtydays of this one hour daily, he was removed permanently from -chis occupation. In conclusion, we have abstracted the high points of our dispensary record and will bo glad to submit further information should it be requested. K&K/MG ll-xx